October/November 2016
Inside: PREPARING FOR ZIKA WOMEN IN PHARMACY INSURER RATE HIKES
Robbery, burglary, and diversion in Georgia — and what you can do
Taking Pills
Student loan refinancing for GPhA members SoFi saves pharmacist borrowers an average of $448 a month1
Apply through SoFi.com/GPhA to get a 0.125% rate discount2 on student loan refinancing.
Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. See sofi.com/ legal for a complete list of terms and conditions. SoFi loans are originated by SoFi Lending Corp (dba SoFi) California Finance Lender #6054612. NMLS #1121636. 1Monthly savings calculation is based on all SoFi members with a pharmacist degree who refinanced their student loans between 7/1/15 and 6/30/16. The calculation is derived by averaging the monthly savings of SoFi members with a pharmacist degree, which is calculated by taking the monthly student loan payments prior to refinancing minus the monthly student loan payments after refinancing with SoFi. SoFi’s monthly savings methodology for student loan refinancing assumes 1) members’ interest rates do not change over time (projections for variable rates are static at the time of the refinancing and do not reflect actual movement of rates in the future) 2) members make all payments on time. SoFi’s monthly savings methodology for student loan refinancing excludes refinancings in which 1) members elect a SoFi loan with a shorter term than their prior student loan term(s) 2) the term length of the SoFi member’s prior student loan(s) was shorter than 5 years or longer than 25 years 3) the SoFi member did not provide correct or complete information regarding his or her outstanding balance, loan type, APR, or current monthly payment. SoFi excludes the above refinancings in an effort to maximize transparency on how we calculate our monthly savings amount and to minimize the risk of member data error skewing the monthly savings amount. 2 If you apply through SoFi.com/GPhA and are approved, the interest rate shown in the Final Disclosure Statement will include an additional rate discount because of your organization’s SoFi partnership at the time of loan origination. Offer good for new customers only.
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COVER STORY: TAKING PILLS Robberies and burglaries continue to plague pharmacies in Georgia (and across the country). Here are some stories — and the experts’ tips on how to prevent and react to theft and diversion from outside your pharmacy ... and in.
3 prescript Your autumn to-do list Three must-do items for every pharmacist
We was robbed! Pharmacists’ responsibilities if they’re robbed or burglaized
4 news
23 keeping pace
What’s up in the Georgia pharmacy world Women in pharmacy, insuring the uninsured, members make the news, and more
25 PharmPAC
10 zika Fight the bite Eradicating myths about the Zika virus
11 calendar
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12 legal injection
Upcoming events
GPhA’s stake in the Pace Alliance continues to pay off
Investors in the future of pharmacy in Georgia
27 contact us Who does what at GPhA — and how to reach us
28 postscript A message from President Lance Boles
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Georgia Pharmacy magazine is the official publication of the Georgia Pharmacy Association. Unless otherwise noted, the entire contents of this publication is licensed under a Creative Commons AttributionNonCommercial-ShareAlike 4.0 International license. Direct any questions to the editor at akantor@gpha.org.
President and Chair of the Board Lance Boles President-Elect Liza Chapman First Vice President Tim Short Immediate Past President Tommy Whitworth
Director of Communication & Editor Andrew Kantor akantor@gpha.org Art Director Carole Erger-Fass
Chief Executive Officer Scott Brunner, CAE sbrunner@gpha.org
Georgia Pharmacy is distributed as a regular membership service, paid for with membership dues. Non-members can subscribe for $50 per year domestic or $65 per year international. Single issues are $10 per issue domestic and $20 international. Practicing Georgia pharmacists who are not members of GPhA are not eligible for subscriptions.
POSTAL
ADVERTISING
All advertising inquiries should be directed to Denis Mucha at dmucha@gpha.org or (770) 252-1284. Media kit and rates available upon request.
October/November 2016
SUBSCRIPTIONS
Georgia Pharmacy (ISSN 1075-6965) is published bimonthly by the GPhA, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA 30328. Periodicals postage paid at Atlanta, GA and at additional mailing offices. POSTMASTER: Send address changes to Georgia Pharmacy magazine, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA 30328.
Georgia Pharmacy
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prescript
Opportunities, knocking HERE’S A 3-POINT AUTUMN TO-DO LIST FOR PHARMACIST LEADERS LOOKING TO ELEVATE YOUR PROFESSION.
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Get briefed … at one of GPhA’s autumn regional Legislative Briefing dinners. You’ll hear what you need to know about our 2017 legislative priorities (it’s an ambitious, important agenda!) and you’ll walk away prepped to discuss those issues with your legislator. You’ll also get an hour of CPE credit, supper, and great face-time with pharmacist colleagues in your area. Briefing dinners start October 4 and run through November 15. Go to GPhA.org/briefings to register for the one nearest you.
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Go vote … on November 8. It’s Election Day 2016, and the entire Georgia General Assembly is up for election. Later this year PharmPAC will send out a list of candidates who back pharmacy — they’ll have been evaluated based on their votes on your behalf and their demonstrated support for pharmacy and the patients you serve. If your pharmacy practice is a factor in your voting decision, you owe it to yourself to consider PharmPAC’s recommended candidates. After all, these are the folks we’re counting on to carry our legislative priorities come January.
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Grab coffee … with your legislators — and brief them on those pharmacy legislative priorities. Much about pharmacy is complicated — practically a foreign language. You need to be the interpreter. It’s essential that we brief them before they come to Atlanta in January, and you’re the person who understands the issues —more importantly, you’re a constituent. Reach out now and invite your state representative and senator to your pharmacy so they can see first-hand the services you provide and can hear your concerns on your turf. And have a fresh pot of java ready. Georgia Pharmacy A S S O C I AT I O N
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Grow your leadership skills… at GPhA’s November 20 Women’s Pharmacy Leadership Symposium this November. Women have certainly made strides in the pharmacy profession, but for some it still can often seem like a “man’s world.” But the fact is, men and women communicate and lead in different ways. As more women enter pharmacy in growing positions of influence, there is a call to focus leadership development on issues specific to women and what it means to be a professional trailblazer. This workshop is specifically designed for women in entry- and mid-level management positions in the profession. This live, classroom program focuses on developing strategies for increasing your lead and to influence others. For details and to register, go to GPhA.org/women-in-pharmacy. Scott Brunner, CAE, is GPhA’s chief executive officer. Contact him at sbrunner@gpha.org. October/November 2016
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news IMPORTANT: LICENSE RENEWAL HAS BEGUN The Georgia Board of Pharmacy has begun the online renewal process for active pharmacist and nuclear pharmacist licenses. All pharmacists must renew their licenses this year. For more information, visit the board’s website at gadch. mylicense.com/eGov. Remember: All pharmacist and nuclear pharmacist licenses expire on December 31, 2016. And if you’re lacking the required CPE credits, now’s the time to fix that: Check out GPhA.org/education for lots of opportunities for members.
MANY SENIORS AREN’T TAKING THEIR BLOOD PRESSURE MEDS Almost half of seniors with high blood pressure aren’t taking their meds, according to the CDC — probably because they feel fine ... at least until they have a heart attack or stroke. It’s a good reason to talk to them about the importance of maintenance drugs.
read more @ gphabuzz.com
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RISING TO THE TOP: A LEADERSHIP SYMPOSIUM FOR WOMEN IN PHARMACY The evidence is undeniable -- so much so that it probably doesn’t much qualify for news at this point: Women are entering the pharmacy profession at higher rates than men. If you want to put a sharper point on that, here you go: According to the American Association of Colleges of Pharmacy, of the total number of students enrolled in first professional degree programs for fall 2015, 61.4 percent were women. Both research and experience tell us that men and women communicate and lead in different ways. What does this pharmacy gender gap mean for pharmacy leadership? We can assume we’re in for a paradigm shift. Some would argue the shift is already well underway. Management expert Dr. Jan Flynn of Georgia College believes that it’s time to focus leadership
development on issues specific to women, and she’s coming to GPhA to spread that message — in a sixhour live symposium for women in pharmacy. In Rising to the Top: A Leadership Symposium for Women in Pharmacy, Dr. Flynn will explore strategies for women in the pharmacy world that will help them be their best — as coworkers, practitioners, and managers. There will be time for discussing issues of management and leadership, with the ultimate goal of building a community of women in phamracy who support one another’s careers. The date is November 20, 2016. The cost is $200, including lunch. To register or to find out more about this unique opportunity, go to GPhA.org/women-in-pharmacy. October/November 2016
Insuring uninsured Georgians: three plans How do you offer access to health insurance for poor Georgians without looking like you’re supporting Obamacare and Medicaid expansion? A bipartisan task force from the Georgia Chamber of Commerce offers several plans, according to Georgia Health News. The issue is this: How do you help the hundreds of thousands of adult Georgians who don’t have children and earn between about $4,039 and $11,880 per year — too much to qualify for Medicaid, but too little to qualify for federal tax credits for insurance? The Georgia legislature’s stance has been ‘you don’t.’ That’s beginning to change, though, as more states either expand Medicaid to more childless adults (like Louisiana) or develop an alternative (like Arkansas). As of 2015, Georgia ranked 46th in the country for healthcare coverage. The task force suggested three options: 1) Provide Medicaid coverage to
childless adults who earn less than 100 percent of the federal poverty level ($11,880 per year) — that’s about 565,000 people. 2) Simply enroll adults who earn up to 138 percent of the poverty level (about $16,394) in Medicaid. 3) Use Medicaid funds to enroll those people in private insurance plans. If approved, the federal government would pay 100 percent of those Medicaid costs until 2020, when it would drop to 90 percent. And what about the costs after 2020? It turns out that expanding coverage to the uninsured actually brings more money into the state. The Urban Institute did an analysis and found that — thanks to a combination of increased healthcare and related jobs (yes, including pharmacists and techs), plus the increased productivity of Georgians who were healthier — “For each dollar that Georgia would have to spend on Medicaid expansion, it would gain $8.68 to $9.42 in federal spending.”
2017 INSURER RATE HIKES IN GEORGIA The 587,000-plus Georgians who buy individual health plans — i.e., they don’t get it through their employers — are looking at rate increases across the board from the state’s insurers next year. (Note that in many cases federal tax breaks will keep the costs lower for policyholders.) HUMANA
67.5 % HARKEN HEALTH
51 % ALLIANT
21 % KAISER PERMANENTE
MARK YOUR CALENDARS
Day at the Dome dates (plural!) Due to the overwhelming number of participants this past year (more than 400), GPhA is scheduling two Pharmacy Days at the Dome for 2017. The event(s) provide an opportunity for student pharmacists to advocate for pharmacy, and for GPhA to flex its political muscle by filling the halls of the state capitol with white-coated practitioners-to-be.
To accommodate the large number of attendees — and assure better interactions with lawmakers — two schools of pharmacy will participate on each of the two dates, as follows:
January 31, 2017: UGA and PCOM February 21, 2017: Mercer and South
17.6 % AMBETTER (PEACH STATE)
15.6 % Why the increases? Part of the Affordable Care Act requires the federal government to pay insurers to help offset the additional costs incurred by their insuring less-healthy people, but Congress hasn’t actually approved the money. So insurers have to pass the costs along until Congress gets its act together. Source: Georgia Office of Insurance
October/November 2016
Georgia Pharmacy
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news
Representing pharmacists and pharmacies before the Georgia Pharmacy Board, GDNA and DEA.
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The good folks at the California Pharmacists Association have a bunch of free high-quality flyers, signs, and more you can download and print — it’s a ‘back to school immunization media kit’ available at CPhA.com/backtoschoolkit. (Note that it’s CPhA, not GPhA.) Good stuff for your windows and counter.
GEORGIA LOOKS TO BAN SYNTHETIC OPIOID U-4 You can buy U-4 (aka U-47700) online for about $40. One Floyd teen may already be dead from overdosing on the powerful (7.5 times stronger than morphine!) painkiller. So now at least one Georgia senator is looking to ban it, and quickly. Senator Chuck Hufstetler of Rome is hoping Governor Deal will pass an executive order outlawing U-4 it, rather than waiting for the legislature to convene next year.
REMEMBER: NO FLUMIST THIS YEAR In case you forgot, don’t be giving patients FluMist this year. It (probably) doesn’t work. Both the CDC and the American Academy of Pediatrics say so and recommend regular shots for patients. Even kids. Have the lollipops ready. 6
Georgia Pharmacy
October/November 2016
AETNA WON’T SELL INDIVIDUAL HEALTH PLANS IN GEORGIA ANY MORE
Patients won’t be able to buy individual health insurance plans from Aetna in Georgia in 2017. In retaliation for the government’s refusal to approve its merger with Humana, Aetna has pulled out of all insurance exchanges; the U.S. Senate is investigating the company f0r the move. (Aetna will still offer group-coverage plans through employers.)
NCPA PRESIDENT CALLS OUT PBM PRICING Brad Arthur, president of the National Community Pharmacists Association, recently appeared on CNBC where he let his feelings on the PBM industry be known — specifically, the lack of pricing transparency around it. “There’s a huge issue with the PBMs,” he said. “They operate within a sphere of secrecy.” The PBM industry is hiding behind this notion that they’re managing costs on behalf of payers, when in fact they’re doing nothing more than preserving their particular segment of healthcare spending.” Check out GPhA. org/arthurcnbc for the video.
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October/November 2016
- Patient medication consultation - MTM & adherence support - Immunizations - Specialty prescriptions Georgia Pharmacy
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news
NCPA’S CONVENTION IS COMING OCTOBER 15 Our friends at the National Community Pharmacists Association are having their annual convention in New Orleans, October 15–19. It’s full of courses, workshops, strategies, networking… you get the idea. If it’s anything like last year, you’ll be joining more than 3,000 community pharmacists from around the country… and be talking about it for weeks. Visit NCPAnet. org for more.
MEMBERS IN THE NEWS Sharon Sherrer honored by ACA GPhA past president Sharon Sherrer of Marietta ( above) — the 2016 recipient of GPhA’s Larry L. Braden Meritorious Service Award — has been honored with the
2015-16 Albert E. Rosica, Jr. Memorial Award from the American College of Apothecaries Research & Education Foundation. The award is presented each year “to a pharmacy practitioner for his or her contributions to pharmacy education through participation in pharmacy clerkship programs, serving on various college committees, teaching, working with the alumni association, and making other contributions to academic programs.”
Helping seniors at home — meet Sharon Clackum A big shout-out to Georgian Sharon Clackum, a geriatric pharmacist featured in the August Pharmacy Today (GPhA.org/sclackum) for her work helping seniors continue living at home.
AARP turns to Mercer’s Susan Miller for advice Susan Miller, a GPhA member and professor and chair of the Department of Pharmacy Practice at Mercer, was the main source in an AARP story on when to switch to generics… and when not to: “9 Types of Medications You Should Think Twice About Replacing.” Read it at GPhA.org/smiller. 8
Georgia Pharmacy
October/November 2016
GEORGIA PHARMACY CHAMPS SPEAK TO CONGRESS Your Georgia congressmen are working for you: U.S. representatives Buddy Carter, Doug Collins, and Austin Scott spoke on the House floor during a special order session of Congress. They were urging support of the Pharmacy and Medically Underserved Areas Enhancement Act, which would allow Medicare to reimburse pharmacists for the clinical services they can provide. Carter in particular highlighted the lack of physicians in many rural areas of the country. Provider status for pharmacists, Carter explained, would yield dividends not only for patients, but for healthcare costs as well. Collins encouraged a hearing on the Pharmacy and Medically Underserved Areas Enhancement Act, which would allow Medicare beneficiaries in “medically underserved areas” to use services provided by pharmacists through Medicare Part B. “Pharmacists are the most accessible healthcare professionals out there,” Carter said. “We in America, if we are ever going to get our healthcare costs under control, we have to take advantage of that.” October/November 2016
MEET BLINK HEALTH Blink Health says it can reduce the price of generic meds. Here’s the idea: Search for a medication on BlinkHealth.com. If you like the price, you pay right there, on the site. Then you “Fill your prescription at your pharmacy like you normally do. Show the
pharmacist your Blink Card and ask to process Blink as the primary payor. Your copay is $0.” According to Blink, it’s accepted “at your local pharmacy and all major chains,” and its prices can be less than some insurance co-pays.
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Learn more at www.medicationsafety.org or call us at (866) 365-7472. The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO).
Georgia Pharmacy
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news GEORGIA NEAR THE BOTTOM FOR HEALTH COVERAGE Georgia ranks third worst in the nation for health coverage, with it’s 13.9 percent uninsured putting it ahead of only Texas and Alaska, according to the latest data from the Census Bureau. And with 1,388,000 uninsured people, Georgia also ranks fourth worst in sheer number. In the meantime, the national rate of uninsured people is at the lowest level recorded: 8.6 percent.
read more @ gphabuzz.com
Uninsured Rates by State: 2015 (civilian noninstitutionalized population)
Source: Kaiser Family Foundation
You are a leader—an educator, a trusted advisor, a counselor. Let us help you manage your day-to-day business so you can focus on what matters most—your patients. To learn more, visit cardinalhealth.com/ communitypharmacyadvantage © 2016 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO are trademarks or registered trademarks of Cardinal Health. Lit. No. 1RI16-529023 (06/2016)
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Calendar October 4 – November 15 GPhA Regional Legislative Briefings Various locations: See back page for details GPhA.org/briefings/fall2016 October 15–19 2016 NCPA Annual Convention, New Orleans ncpanet.org/meetings/annualconvention November 3 CPEasy webinar: The False Claims Act and Pharmacies (7:30 PM; 1.5 hours CPE) GPhA.org/cpeasy
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November 10 CPEasy webinar: Pharmacies and Their Relationships with Prescribing Physicians and Beneficiaries (7:30 PM; 1.5 hours CPE) GPhA.org/cpeasy November 17 CPEasy webinar: Confronting Drug Diversion (7:30 PM; 1.5 hours CPE) GPhA.org/cpeasy November 20 Rising to the Top: A Leadership Symposium for Women in Pharmacy GPhA.org/women-inpharmacy
October/November 2016
zika
Fight the bite
ERADICATING THE MYTHS ABOUT THE ZIKA VIRUS BY RIYA PAULOSE As pharmacists, you’ve got the power and the street cred to calm your patients about Zika. And the CDC and WHO have a great deal of information about the Zika virus — information you should know and spread to equip patients (and yourself) with the tools they need. For starters, help dispel some common myths about Zika. MYTH: All mosquitoes can carry the Zika virus. FACT: Only two species do:: Aedes aegypti and Aedes albopictus. Ae. albopictus are known to span all over Georgia but the Ae. aegypti are only found in certain parts of the state, usually in residential areas. MYTH: Mosquitos need a large amount of water to lay their eggs. FACT: As little as a bottle cap full is all they need to lay a few thousand eggs. Note, however that it must be standing water; that’s why devices such as fountains and “water wigglers” prevent them from laying eggs in ponds and bird baths. MYTH: People infected with the Zika virus exhibit obvious symptoms. FACT: Only about one in five patients who test positive for Zika experience any symptoms at all, and those are usually mild: conjunctivitis, fever, rash, arthralgia, and joint pain.
ingredients: picaridin, DEET, IR3535, or oil of lemon eucalyptus — aka para-menthane-diol. Nothing else has been confirmed to actually repel mosquitos. MYTH: The Zika virus is being locally transmitted in Georgia FACT: The cases of Zika in Georgia have all been travel related. As of mid-September 2016, there has not been a single report confirming the virus was obtained from a local mosquito bite.
WHILE WE’RE WAITING FOR A VACCINE, TAKE PREVENTATIVE MEASURES. Georgia pharmacists can help by… n providing patients with accurate, up-to-date information on Zika: causes, prevention, and what signs and symptoms to watch for; n encouraging pregnant women to take advantage of CDC’s resources and testing algorithms; n educating patients on safe/protected sex; n handing out pamphlets to patients that provide information about how to detect, test, and report the Zika virus; n staying up to date with the progress being made by CDC and WHO. Georgia Pharmacy A S S O C I AT I O N
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MYTH: The virus can only be transmitted via mosquito bites and from mother to infant. FACT: The Zika virus can also be transmitted via blood transfusions and unprotected sex with a male. Even if the man does not show symptoms during intercourse, the virus can still be passed on to his partner. And no, there is no evidence of Zika virus transmission via breast milk. MYTH: Any insect repellant will protect against bites from mosquitos. FACT: The CDC says you should only use EPA-registered insect repellants that include one of the active October/November 2016
Riya Paulose is a Mercer University student pharmacist who completed a rotation in pharmacy association management with GPhA this summer.
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Georgia Pharmacy 11
legal injection
We was robbed! Greg Reybold, GPhA ‘s vice president of public policy and association counsel, answers your questions about Georgia pharmacy law. This isn’t legal advice, of course, just his interpretation of the law.
What are some of the legal implications arising out of a robbery or burglary of a pharmacy? If your pharmacy has been robbed or burglarized, there are a number of implications, some of which are GREG REYBOLD specific to the health care and pharmacy field. Generally, filing a police report and notifying your insurance carrier in a timely fashion are necessary steps for all businesses. Also, in the event that there were employees or customers injured, there will likely be other considerations: notifying the business’s liability carrier and, for injured employees, complying with applicable Georgia Workers’ Compensation requirements — including preparing the Employer’s First Report of Injury form immediately after knowledge of the injury and forwarding it to the businesses insurer. That in and of itself is a lot. Unfortunately, for pharmacies, it doesn’t stop there. Notification to the pharmacy’s wholesaler will likely be necessary, and there may be specific contractual notification requirements in that regard. Moreover, and as I’ll
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explain below, there are also Board of Pharmacy requirements and, when the loss involved controlled substances, federal reporting requirements. If there was a burglary or robbery attempt but nothing was actually taken, am I subject to any reporting requirements under Board of Pharmacy Rules? Georgia Board of Pharmacy rules provide that “thefts or breakins” require immediate notification to the Board of Pharmacy. Thus, if there is a breakin and nothing was actually taken, you still must notify the Board. With regard to an attempted robbery where nothing was actually taken, it does not appear that Board Rules require notification. Nonetheless, the prudent course of action would be to notify the Board immediately anyway. What are the Board of Pharmacy notification requirements when a robbery or break-in has resulted in some type of loss? As I explained above, the Board of Pharmacy provides that “thefts” require immediate notification to the board. Note that the word “theft” doesn’t specify what is stolen. Thus, it appears theft of anything from a pharmacy requires immediate notification to the board. In the case of a theft or loss of drugs or devices, the rule requires immediate notification to the board and to GDNA; immediate notification is defined to mean “written notification sent within 24 hours of the event.” With regard to the theft of controlled substances, the board requires notification to GDNA and the DEA within three days of discovery of a theft, loss, or unaccounted for controlled substance. Of note, this three-day requirement appears to be inconsistent with the immediate notification requirement and federal regulations on this point. As such, providing notification within one business day would be advisable. The rule also requires sending a DEA form 106 to GDNA and DEA within 10 days of receipt of the report. Finally, the board also requires immediate October/November 2016
“CALLOUT GOES HERE SEEING FROM MANY OUTSIDE ORGANIZATIONS SUCH AS THE CDC, THE NATIONAL GOVERNORS ASSOCIATION, THE SURGEON GENERAL, AND OTHERS.” notification when there has been a theft, destruction, or loss of records required to be maintained under state or federal law.
writing within one business day of discovery of such loss or theft. Note, this is stricter than GDNA rules, which require notification to the DEA within three days of discovery. Federal regulations also require completion of DEA form 106, although federally no time limit is specified. Also, pharmacies need to be aware of the HIPAA Breach Notification rule, in the event patient health information is breached or stolen. When there is a breach, notification is required to the individuals affected, to the Secretary of Health and Human Services (different timelines depending on size of breach), and to the media in certain circumstances. Georgia Pharmacy A S S O C I AT I O N
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Are there any federal requirements when a robbery or break-in has resulted in some type of loss? Yes, when there has been a theft or significant loss of controlled substances, federal regulations require notification to the DEA field office in
Use of this article, or the information it contains, does not constitute any legal advice, does NOT establish any attorney-client relationship, and does NOT create any legal duty on the part of the author or the Georgia Pharmacy Association. When making a decision that may have legal consequences, readers should consult with qualified legal counsel.
DO YOU HAVE AN ISSUE YOU’D LIKE TO SEE ADDRESSED IN THIS COLUMN? LET US KNOW — SUBMIT IT TO GREG AT GREYBOLD@GPHA.ORG.
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cover story
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October/November 2016
Taking Pills Robbery, burglary, and diversion in Georgia — and what you can do
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BY ANDREW KANTOR
et’s follow the dominoes: We’ve known how addicting opioids are since at least the Civil War. We tried to limit their use (in 1924 heroin became illegal), but patients were still in pain. Over the decades pharmaceutical companies developed alternatives — think Percocet and Vicodin — even as doctors were hesitant to prescribe them. Then came the ’90s when the pendulum swung. There was a push to treat pain more. They called it “the fifth vital sign,” and doctors were urged to prescribe painkillers, not the least by the pharmaceutical companies. Hospitals were (and still are) judged in part by patients’ pain levels. Welcome OxyContin. Painkiller prescriptions skyrocketed, increasing four-fold just from the early to the mid-1990s, according to the National Institute on Drug Abuse. And with those prescriptions came a high ... and addiction. Come the 2000s and the pendulum swung back. Restrictions tightened as we realized the problem. Pain clinics shut down, “doc shopping” was tracked, prescription drug monitoring programs were established. The supply and availability of opioids were squeezed. But not the demand. Result: Millions of people are addicted to drugs that have become much harder to get. And where there’s a demand like that, you can bet someone will find a way to meet it — legal or, more often, illegal. In case you haven’t heard, pharmacies are being robbed and burglarized, and the target in almost every case is painkillers.
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cover story • In Athens, Dublin, and Atlanta, employees were threatened with guns • In Colbert, thieves broke in overnight • In Snellville they took a sledgehammer and came through the wall • In Dublin, they used a boxcutter and the threat of a gun • In Conyers, three pharmacies were burgled over four nights That’s only a partial list — and it’s only from the first half of 2016. It’s what happens when you’re storing thousands of dollars’ worth of products people are literally dying to get hold of. Often the thieves are caught on video (crawling on the floor to avoid motion detectors in one case, using that sledgehammer in another), and the next day’s news story has the line “...the suspect got away with oxycodone and hydrocodone pills.” And unlike other businesses, pharmacy owners may face legal issues if they can’t account for inventory — not to mention some significant cashflow issues, too. Before we talk about what’s happening and what you can do, let’s get some terminology out of the way. In law enforcement, the universe of people illegally acquiring prescription drugs is called drug diversion. It includes breaking in, armed robbery, faking prescriptions, hijacking trucks... the whole enchilada. We’re only concerned with some parts of that universe here: Robbery: When an outsider demands the pharmacy staff give them medications, usually with the threat of force. Theft or burglary: When someone physically breaks into the pharmacy during off-hours to steal medication, with no threat of force involved. Internal theft: When insider steals medication using his or her position (e.g., an employee), either by physically taking it or by altering paperwork. So yes, you’re fighting at least a three-front war. And you means pharmacists, techs, and employees — at big pharmacies and small ones, chains and independents. A quick search of news stories in Georgia and you’ll see a long list of chain and independent pharmacies that have been victims just this year. And let’s not forget the state’s 2016 poster child for internal theft: Emory University Midtown Hospi18 Georgia Pharmacy
tal. But we’ll get to that in a moment. Different kinds of pharmacies face different threats. Chains are much more likely to be the victims of internal theft, while independents are more likely to be burglarized, according to Pharmacists Mutual Insurance Company. (See the box, “Who’s robbing who?”) Both, however, are equally susceptible to armed robbery. So let’s look at that first.
DETERRENCE In the 12 months from July 2015 through June 2016, there were 18 pharmacy robberies reported in Georgia — at least 18 in which controlled substances were stolen, anyway — according to Dennis Troughton, PharmD, of the Georgia Drugs and Narcotics Agency. In total, thieves made off with 41,481 doses of C-IIs, he said, in pill or liquid form. In some cases they brandished knives. In others, guns. In others, the threat of a gun. Do we have to say this? When preparing for the possibility of armed robbery, the number one goal is no one gets hurt. At the end of the day, money is just money, pills are just pills. You want to do what you can to prevent a robbery, but if it does happen your goals are simple: 1. Make sure no one gets hurt. 2. Make it as easy as possible for law enforcement to catch the thief. But first, prevention. You can’t prevent someone from attempting to rob you, but you can take steps to deter them. Top of the list, be obvious about it. If you have cameras (hidden or otherwise), announce that fact clearly. It also helps if you say that the video is stored offsite. (See the box, “Cameras, candidly.”) CVS, Kroger, and Walgreens, for example, have begun installing time-delay safes in their pharmacies for schedule II drugs. There’s a waiting period — five, 10, 15 minutes — before they can be opened. More importantly, though, they make it clear that the safe is on a delay; advertising the fact is what makes it most effective. A robber knows he’ll have to wait before the drugs will be available, and time is not on his side. (Walgreens wouldn’t talk to us for this story, but in 2014 the company did tell Drug Topics magazine that it’s seen a “dramatic reduction” in crime thanks to those safes.) Another potential step is to require than anyone entering the store remove hats, sunglasses, and October/November 2016
THREATS BY BY PHARMACY THREATS PHARMACYTYPE TYPE CHAIN PHARMACIES
ROBBERIES
ROBBERIES BURGLARIES
INDEPENDENT PHARMACIES 31%
36%
6%
EMPLOYEE THEFT
6% 58%
EMPLOYEE THEFT
66%
BURGLARIES
Source: Pharmacists Mutual
hoodies. If your store have a panic button, someone refusing to comply might gain you a few extra seconds to reach or push it. And consider installing a measuring tape at your doors (public and non-public) to help determine the robber’s height, assuming you have video cameras. Pharmacists Mutual, the DEA, and the security experts at RxPatrol agree that staff training is crucial. It should cover preventing (or at least deterring) a robbery, signs to watch for (e.g., someone ‘casing the joint’), and what to do if confronted by a thief. RxPatrol, in fact, offers free training videos at rxpatrol.com, and recommends contacting your local police about educating staff. In short, you need to be prepared and be trained.
COOPERATE AND OBSERVE What happens if you do get robbed? Rule #1: Cooperate. No amount of inventory or paperwork is worth someone’s life. (And that includes the thief’s. If you think there are a lot of legal issues if your narcotics are stolen, they’re nothing compared to what would happen if you killed or injured someone.) The DEA is clear about this: “Do not resist!” it says. “Cooperate fully with the robber … do exactly what you are told to do, nothing more and nothing less.” That said, you should be preparing for the police later. Make mental notes on the robber(s), says the DEA, especially what can’t be changed: Age, height, weight, tattoos, scars, left- or right-handedness, and other body features. It may seem like forever, but most robberies October/November 2016
are over within a minute. Once that happens, you want to dial 911 and/or sound the alarm and treat anyone who’s injured. Then lock the doors and keep them closed until police arrive — yes, that means asking witnesses to stay. And write down everything you remember about the robber. Have anyone else in the store do the same, ASAP. Memory is incredibly fleeting and fickle. Hand out pens and paper, and explain to staff and customers what’s going on. Protect the crime scene, too. Don’t touch anything the robber has (think: door handles), and if he passed a note, be sure you know where it is — but don’t touch it. The statistics aren’t great — only about twothirds of pharmacy robberies are solved — but every step you take and take quickly can put the odds in your favor.
WHEN THE CAT’S AWAY Especially for independent, stand-alone pharmacies, burglary is a bigger issue than robbery; they usually aren’t open 24 hours or surrounded by a retail store. (See the box, “Who’s Robbing Who.”) The methods have changed over the years. “Years ago they’d throw a brick through the front window,” said Fred Sharpe of Albany, who owns 28 independent U-Save-It pharmacies in Georgia. He’s been broken into, he estimates, 50 to 60 times over the past 25 years. His preferred method of deterrence is making it as tough as possible to even get into the store … but it’s been an arms race. When he swapped out Georgia Pharmacy 19
2015 Recipients of the “Bowl of H ents 2015 of the “Bowl of Hygeia” Award Recipients of the “Bowl of Hygeia” Award Dan McConaghy Alabama
Nicki Hilliard Arkansas
Jane Krause Indiana
Dan McConaghy Dan McConaghy Alabama Alabama
Tom Van Hassel Tom Van Hassel
Kerri Okamura Kerri Okamura Hawaii Hawaii
Steven Bandy Steven Bandy Illinois Illinois
Arizona Robert Shmaeff Arizona California
Butch Henderson Butch Henderson Maryland Maryland
Nicki Hilliard Nicki Hilliard
Robert Shmaeff Robert Shmaeff California California
Kerri Okamura HawaiiJane Krause
Steven Bandy IllinoisHartig Richard
Arkansas Arkansas Sherman Gershman Connecticut
Richard Hartig Iowa
Jane Krause Indiana Indiana
Robert Nyquist Kansas
Paul Jeffrey Derek Quinn Paul Jeffrey Derek Quinn Massachusetts Michigan MassachusettsButch Henderson Michigan
Maryland
Derek Quinn Michigan Heather Mooney Heather Mooney Nevada Nevada
Richard Crowe Richard Crowe New Hampshire New Hampshire
Gayle Hudgins Montana
David Moody David Moody North Carolina North Carolina
The “Bowl of Hygeia” Kevin Oberlander Kevin Oberlander North Dakota North Dakota
Danny Bentley Danny Bentley Ohio Ohio
David Moody North Carolina
Danny Bentley Ohio
Renee Sutton Renee Sutton
South Dakota Gordon Richards, Jr. Dakota South Oklahoma
Mac Wilhoit Mac Wilhoit
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Terri Smith Moore Terri Smith Moore Washington DC Washington DC
Mac Wilhoit Tennessee
Terri Smith Moore Washington DC
Kevin Musto Delaware
Richard Hartig Iowa Iowa
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Paul Jeffrey Massachusetts
Jenny Houglum Minnesota Gayle Hudgins Gayle Hudgins Montana Montana
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Tom Van Hassel Arizona
Nicki Hilliard Arkansas Sherman Gershman Sherman Gershman Connecticut Connecticut
Fritz Hayes Florida
Jane Krause
Robert Indiana Nyquist Robert Nyquist Kansas Kansas
Lloyd Duplantis Louisiana
Derek Quinn Michigan
Robert Wilbanks Mississippi
The “Bowl of Hygeia” The “Bowl of Hygeia”
Heather Mooney Nevada
Edward McGinley NewRichards, Jersey Jr. Gordon Gordon Richards, Jr. Oklahoma Oklahoma
Kevin Oberlander North Dakota Jim Cousineau Jim Cousineau
Texas Thomas TexasMattei Pennsylvania
Renee Sutton South Dakota David Flynn
David Flynn West Virginia West Virginia
Robert Shmaeff California Kevin Musto Kevin Musto Delaware Delaware
Amy Bachyrycz
Danny Bentley Ohio Marvin Orrock Marvin Orrock Utah Deborah Newell Utah
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Brian Jensen Brian Jensen Wisconsin Wisconsin
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Richard Hartig Robert Nyquist Iowa Kansas Lloyd Duplantis Kenneth McCall Lloyd Duplantis Kenneth McCall
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Florida Ron Stephens Florida Georgia
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New Mexico Ann Zweber Ann Zweber Oregon Oregon
Sherman Gershman Connecticut
Amy Bachyrycz Amy Bachyrycz New Mexico New Mexico
Benjamin Gruda Benjamin Gruda New York New York
Edward McGin New Jersey
The “Bowl of Hygeia”
Benjamin Gruda
Thomas Mattei New YorkDeborah Newell Thomas Mattei Deborah Newell Pennsylvania Rhode Island Pennsylvania Rhode Island
Gordon Richards, Jr. Oklahoma
Sharm Steadman Sharm Steadman South Carolina South Carolina
Ann Zweber Oregon
Thomas Mat Pennsylvani
Marvin Orrock Utah
John Beckne Virginia
John Beckner Gregory Hovander John Beckner Gregory Hovander Virginia Washington VirginiaSharm Steadman Washington
South Carolina
Jim Cousineau Texas
Randy Harrop Randy Harrop Wyoming Wyoming
Jim Cousineau Marvin Orrock John Beckner Gregory Hovander award A. Texas The Utah Virginia developed Washington The Bowl Bowl of of Hygeia Hygeia award program program was was originally originally developed by by the the A. H. H. Robins Robins Company Company to to recognize recognize pharmacists pharmacists across across the the nation nation
for for outstanding outstanding service service to to their their communities. communities. Selected Selected through through their their respective respective professional professional pharmacy pharmacy associations, associations, each each of of these these dedicated individuals individuals has has made made uniquely uniquely personal personal contributions contributions to to aa strong, strong, healthy healthy community. community. We We offer offer our our congratulations congratulations and and thanks thanks dedicated for for their their high high example. example. The The American American Pharmacists Pharmacists Association Association Foundation, Foundation, the the National National Alliance Alliance of of State State Pharmacy Pharmacy Associations Associations and and the the state state pharmacy pharmacy associations associations have have assumed assumed responsibility responsibility for for continuing continuing this this prestigious prestigious recognition recognition program. program. All All former former recipients recipients are are Terri Smith Moore David Flynn Brian Jensen Randy Harro encouraged to to maintain maintain their their linkage linkage to to the the Bowl Bowl of of Hygeia Hygeia by by emailing emailing current current contact contact information information to to awards@naspa.us. awards@naspa.us. The The Bowl Bowl of of encouraged WashingtonDC. DC West Virginia Wisconsin Wyoming Hygeia is on display in the APhA Awards Gallery located in Washington, Hygeia is on display in the APhA Awards Gallery located in Washington, DC. Boehringer Boehringer Ingelheim Ingelheim is is proud proud to to be be the the Premier Premier Supporter Supporter of of the the Bowl Bowl of of Hygeia Hygeia program. program.
David Flynn West Virginia
Brian Jensen Wisconsin
Randy Harrop The Bowl of Hygeia award program was originally developed by the A. H. Robins Company Wyoming for outstanding service to their communities. Selected through their respective professi dedicated individuals has made uniquely personal contributions to a strong, healthy comm their high American across Pharmacists Association Foundation, the National Al a award program was originally developed by the A. H. Robinsfor Company to example. recognizeThe pharmacists the nation
cover story plate glass windows for laminate security glass, for example, thieves would go through the drivethrough window. So he added bars there and reinforced the other entrances. All that goes to goal number one when dealing with potential burglary: Prevent a would-be thief from attempting to steal from you in the first place. That means both making it difficult, and by making it obviously difficult. David Ledbetter of Clarkesville, for example, owner of Clarkesville Drug, was burglarized “semi-successfully” in 2014 when thieves punched out the deadbolt lock on his pharmacy’s front door on the Sunday after Thanksgiving. So he made a few small but significant changes. He got a bigger, better safe — a gun safe, in fact — that he’s bolted to the floor. More importantly, perhaps, is that the safe is obvious to customers. Ledbetter isn’t going for subtle. “The more obvious you are, the more high-profile it is, the better off you’ll be,” he said. “Make it big, make it beefy.” Take another common anti-theft tool: surveillance cameras. They can help catch a thief by identifying him, but they can also help deter one by letting him know he’s being watched and recorded. It all part of the message: Don’t bother trying to rob us. Or, as Pharmacists Mutual puts it, “All things being equal, a criminal is more likely to avoid a ‘hardened target’ if they can.”
HARDENED TARGETS If you can’t deter them from trying, your next step is preventing them from succeeding. Let’s face it, all the warning in the world isn’t going to stop some people. As Valerie NeeSmith, pharmacy sales manager for Kroger’s Atlanta division put it, a warning is great but, “For a person who’s an addict and just desperate, I don’t know that it’s a deterrent.” Alarms are critical, of course. But they have to work and be used correctly. Pharmacist Mutual — which obviously has a horse in the theft-prevention race — recommends having the system professionally installed, testing it regularly, and updating and changing codes, especially if an employee leaves. (“Alarms,” by the way, can mean everything from window-breakage sensors, to motion sensors and October/November 2016
FAST FACTS FROM THE DEA n The most common medications pharmacy robbers seek are
opiates and benzodiazepines, oxymorphone, oxycodone, methadone, Percocet, Xanax, and Valium. n T he typical pharmacy robber is often a white male in his 20s or 30s who wears a hat, sunglasses, or some other material that covers his face. n T he majority of robbery cases involve a note given to pharmacy staff. nM ost pharmacy robberies are over in less than a minute. n6 9 percent of pharmacy robberies are solved.
infrared scanners. And more. You’ve got options.) And talk with your security company and local police about providing the cops with a video feed if your alarm sounds — it’s called a “verified alarm.” With 98 percent of burglar alarms being false ones (according to the Texas Police Chief’s Association), you can’t entirely blame the police if they don’t always respond in seconds; that boy’s cried wolf before. But with a video feed at their disposal, seeing the masked guy rummaging through your shelves will light a fire under the constabulary. You might even get an insurance discount. Oh, and make sure your alarm has a backup in case the phone or power lines are cut. Pharmacist Mutual laments, “Many of the alarms that are taken out do not have any form of line security, such as cellphone back-up, to alert the alarm company of tampering.” Both Fred Sharpe and David Ledbetter go a step further: If their stores’ power is cut, their alarm company will notify them and they can decide whether to investigate. Finally, inspect your premises. Think like a thief. Look for weak spots, and don’t forget to think three-dimensionally; more than one in seven pharmacy burglars enter through the roof or a wall, often from an adjacent property that doesn’t have an alarm. Then reinforce: Good fences make good neighbors, after all. Sharpe is a proponent of a solid defense. “In some places [burglars] have two or three doors they have to bust through,” he said. Georgia Pharmacy 21
cover story Result: Only one burglary in the past three years. (Not that they haven’t tried, he said. He’s found dents in the back door.)
IS IT SAFE? OK, so the Bad Guys get inside. How can you minimize loss? One way you might hear is to keep all your C-IIs in a safe. David Ledbetter gives that a big thumbs-up. That bigger safe he bought isn’t something from the local five-and-dime. He’s clear about the quality issue: Don’t skimp; talk to a gun distributor if you’re not sure. “Get the best you can get,” he says. “If you just get a Mickey Mouse thing, they’re gonna beat the heck out of it or carry it out,” he says. (One suggestion he had: Look for ‘scratch-and-dent’ sales at stores like Tractor Supply Company.) Result: In April 2016, thieves cut his main power supply and broke through the front door via “a big enough rock.” But his heavy-duty safe paid off. The thieves made off with ... some generic Singulair. Good luck selling that on a streetcorner. But there are some downsides to be aware of, and that might explain why about three-quarters of pharmacies don’t have a safe. Losses, according to Pharmacists Mutual, are actually slightly higher in pharmacies with safes. Why? Because thieves do their homework, and only the sophisticated ones are going to bother targeting those locations. They’ll be prepared to disable alarms and break into the safe, and once they get in, all the valuable drugs are in one convenient spot. The reality is, there’s only so much you can do once thieves are inside. Motion detectors add another line of defense, of course, and there are several … interesting options.
WE’RE NUMBER 5 Bad news: According to the DEA, in 2015 Georgia ranked number 5 of the U.S. states for armed pharmacy robberies. The (somewhat) good news: Despite the ranking, there were only 12 armed pharmacy robberies reported that year in the state.
22 Georgia Pharmacy
3SI Security Systems, for example, sells PharmaTracker bottles — containers for narcotics with GPS chips embedded in them. If the bottle leaves the premises, the company can track its location anywhere in the world. And then there are smoke devices, like SmokeCloakDNA. If your alarm is triggered, it fills the store with a harmless smoke to cut visibility — but it also leaves a DNA fingerprint on everything, including the thieves. If they’re caught, you can prove they were in your store. (No, GPhA isn’t endorsing either of these companies. They’re just two examples of some of the more high-tech theft prevention products.) Of course, one of the bigger threats to pharmacies doesn’t need to break into the store at all.
INSIDE JOBS Shall we talk about the elephant in the room when it comes to employee drug diversion in Georgia? Between 2008 and 2013, more than 2 million doses of prescription drugs were stolen from Emory University Midtown Hospital by employees, including 1.2 million doses of Vicodin, 110 gallons (!) of promethazine with codeine, and more than 420,000 doses of Xanax. Internal theft is more likely in a larger facility — a chain pharmacy or, obviously, a university hospital. (Again, see “Who’s robbing who?”) In fact, “We focus most of our efforts on preventing internal theft,” said Kroger’s NeeSmith. And looking at the records, she said, “We found a lot of cases where it’s the person you’d least expect” — the “higher-performing people” who might be looking to keep that extra edge. In some cases, employees grab a few pills here and there for personal use. In others they’re looking to acquire larger quantities they can sell. Sometimes they work alone, sometimes they have accomplices. And in all cases, GPhA’s association counsel Greg Reybold points out, you are culpable as pharmacist in charge. So what are the most common ways employees divert drugs? According to Purdue Pharma, RxPatrol, and the DEA: n Filling prescriptions for deceased patients n Providing unauthorized early refills October/November 2016
CAMERAS, CANDIDLY Closed-circuit video cameras are a popular way to deter theft and potentially assist law enforcement afterwards. But experts from the DEA, Purdue Pharma, and RxPatrol offer some caveats and tips. A combination of visible and hidden cameras is best. Visible to deter theft, hidden in case the thieves try to avoid being caught on them. If you want the cameras to do more than act as a deterrent, invest in high-resolution, low-light-capable models. “Zoom and enhance” to identify criminals only works on TV. The cameras’ recordings should be stored off-site, or at least in a secure, non-obvious location. If possible, some of the cameras should be mounted at eye level, not just from above. And be sure they’re pointed at areas likely to be targeted, including registers and shelves holding controlled substances. And remember that Finally, test the equipment regularly, and re-aim cameras as necessary.
n Filling phony written or called-in prescrip-
tions n Short-filling prescriptions; as NeeSmith pointed out, that’s easiest to do with “as needed” drugs that patients might not be counting n Replacing tablets with “look alike” tablets n Opening bottles/packages, removing tablets, then replacing and gluing the seal So what’s to be done?
FAMILY MATTERS Stopping your employees from stealing is a tough gig. On the one hand, you hired these people because you trust them. You don’t want them to feel like potential criminals every moment they’re at work. It’s a needle to thread: Trust, but verify. Law enforcement and insurers offer some suggestions for doing just that. Do background checks before hiring. (Shameless plug: If you’re a member of GPhA’s PEO, background checks are part of the benefits package you pay for.) Limit access. Not every employee needs access to every area of the pharmacy.
Manage your keys. Don’t allow keys that unlock sensitive areas to be taken off site. (And stamp all keys “Do Not Duplicate.”) Give every employee his or her own alarm code, and change them when an employee leaves. If non-pharmacy staff need to go behind the counter — e.g., repairmen, contractors — make sure they’re escorted at all times. Pay particular attention to waste and returns — those present an opportunity for internal theft. Log and witness everything. Beyond these, NeeSmith has her own recommendations: n Review and reconcile counts of controlled drugs regularly. n Check in inventory quickly — don’t let it sit out. n Review and monitor orders of controls. n Double- or even triple-count controls. The last item is particularly helpful when trying to prevent someone stealing one or two pills. “Personal use cases, quite frankly, are the hardest to catch,” NeeSmith said. Requiring at least one other person to verify a count — to say, “Yes, I agree with you” — makes theft significantly harder, she said. (The third, incidentally, is where Emory slipped up. Pharmacy techs were piggybacking extra orders of controlled drugs onto legitimate ones. The hospital didn’t catch the duplicate orders.) The Georgia Board of Pharmacy is looking at changing some of its rules, including proposing one that would require an electronic “perpetual inventory.” If there’s a material discrepancy in that inventory (say, 20 percent, although that hasn’t been decided) the pharmacy must take a physical inventory and report the findings to GDNA. But that’s still in the works. When all’s said and done — when employees are trained, when alarms are installed, when doors and windows are secured — we all know it’s almost impossible to prevent 100 percent of thieves. It’s a fact of life, especially in a business where you’re dealing in a small but expensive product that’s in high demand on the street. Keep in mind, though, that the precautions you take to prevent go beyond protecting your inventory. They’re also protecting patients and Georgians in general. Every theft you prevent means less out there. As David Ledbetter said, simply, “I don’t want to put drugs out on the street.” Georgia Pharmacy A S S O C I AT I O N
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update
Keeping Pace GPhA’S LONG-TIME STAKE IN THE PACE ALLIANCE CONTINUES TO PAY OFF Way back in 1985, GPhA became a charter member of the Pace Alliance (pacealliance.com) — an independent pharmacy buying group (affiliated with McKesson), that today is owned by us and 18 other state pharmacy associations. It’s turned out to be a good investment on our part — Pace has been providing GPhA with a solid revenue stream (read: More money to work for Georgia pharmacists). Its 2015 contributions to GPhA were the highest in a decade, and 2016 is already looking to be a great year. In fact, that’s one of the two goals of the Pace
Alliance: Not only is it owned by state pharmacy associations, it distributes all its profits to them, to fund programs and projects supporting pharmacy at the state level. The other goal is to “advocate and negotiate on behalf of Pace member independent pharmacies in order for them to continue to be viable and competitive.” Pace membership is open to independent pharmacies nationwide. To learn more about how the Pace Alliance can serve your pharmacy, contact Curtis Woods at (785) 843-6912. —Andrew Kantor
We don’t just fill your prescriptions, we fill your needs. fred’s Pharmacy offers a variety of services to help you live a happier, healthier life. • Knowledgeable and caring pharmacists • Immunizations offered daily • Free blood pressure screenings • Website and Mobile App to manage your prescriptions • 90-day prescription refills • Medicare Part D information resource • $4 Prescription Plus Program on generics • And more!
OurVision: A smile on every patient’s face! October/November 2016
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SUNDAY, OCTOBER 23, 2016
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MACON MARRIOTT & CENTREPLEX
SAVE THE DATE
AIP FALL MEETING 3 Hours of CPE Credit CONTINENTAL BREAKFAST & LUNCH PROVIDED
AGENDA Registration opens at 7:00 a.m. Programs include: • High Performance Network update • Counseling Your Patients on Drug Induced Nutrition Depletion and Vitamin Supplementation • The Unaccountable Pharmacy: Accounting Fundamentals and Tax Strategies for Retail Pharmacies • 340B Made Easy- The Nuts & Bolts for a Successful 340B Contract Pharmacy • Tips and Tricks- Preparing for and Surviving a PBM Audit Plus • Legislative Update • Networking with Partners
SHOW YOUR SUPPORT — ATTEND THIS YEAR’S AIP FALL MEETING Registration: Please fill out and fax back to (404) 237-8435 Member’s Name: Nickname: Pharmacy Name: Address: E-mail Address (please print): Will you be joining us for lunch (Noon – 1:00PM)? q Yes
q No
How many total will be attending? Names of Staff/Guests:
INVESTING IN PHARMPAC IS INVESTING IN YOUR PRACTICE. 2016 PHARMPAC INVESTORS The following pharmacists, pharmacy technicians, students, and others have joined GPhA’s PharmPAC. The contribution levels are based on 2016 investment as of August 31, 2016. Titanium Investors ($2,400 or $200/month) Diamond Investors ($4,800 or $400/month)
RALPH BALCHIN Fayetteville
TOMMY BYRAN St. Simons Island
BEN CRAVEY Hawkinsville
NEAL FLORENCE LaFayette
DAVID GRAVES Macon
LON LEWIS St. Simons Island
TOMMY LINDSEY Omega
BRANDALL LOVVORN Bremen
JEFF SIKES Valdosta
DEAN STONE Metter
CHARLIE BARNES Valdosta
MAC McCORD Atlanta
SCOTT MEEKS Douglas
FRED SHARPE Albany
Gold Investors ($600 or $50/month)
Platinum Investors ($1,200 or $100/month)
William Cagle Hugh Chancy Keith Chapman Wes Chapman Dale Coker Billy Conley Blake Daniel Al Dixon Jack Dunn Robert Hatton Cassie Hayes William Huang Marsha Kapiloff Ira Katz Jeff Lurey Jonathan Marquess Drew Miller Laird Miller
Mark Parris Wallace Partridge Houston Rogers Daniel Royal Tim Short Teresa Smith Carl Stanley Dennis Strickland Chris Thurmond Danny Toth Alex Tucker Tommy Whitworth
James Bartling Nicholas Bland Lance Boles William Brewster Bruce Broadrick Liza Chapman Marshall Curtis Mahlon Davidson Sharon Deason Robert Dickinson Ed Dozier Kevin Florence Kerry Griffin Michael Iteogu Stephanie Kirkland Ashley Kunkle George Launius
Mack Lowrey Chad McDonald Bobby Moody Sujal Patel William Prather Greg Reybold Daryl Reynolds Brian Rickard Andy Rogers John Sherrer Sharon Sherrer Danny Smith Michael Tarrant James Thomas William Turner Chuck Wilson H.D. Wilson Steve Wilson
David Graves, Macon, PharmPAC chairman
October/November 2016
Georgia Pharmacy 25
2016 PHARMPAC INVESTORS Silver investors ($300 or $25/month) Renee Adamson Smith Michael Adeleye Nelson Anglin Michael Azzolin Larry Batten James Carpenter David Carr Jean B Cox Gregory Drake Yolanda Ellison Marshall Frost Amy Galloway James Jordan Susan Kane Willie Latch Tracie Lunde Kalen Manasco Pamala Marquess Hillary Jack Mbadugha Bill McLeer Donald Piela, Jr. Steven Purvis Terry Shaw Jonathan Sinyard Kenneth Rogers Austin Tull Lindsay Walker Bronze investors ($150 or $12.50/ month) Bonnie Ali-Warren Phil Barfield Waymon Cannon Sharon Clackum
Michael Crooks Mandy Davenport Melanie DeFusco Wendy Dorminey John Drew Bill Dunaway Benjamin DuPree James Elrod Sheri Gordan Larry Harkleroad Hannah Head Phillip James Brenton Lake Micheal Lewis Mary Meredith Amy Miller Jonathan Riley Amanda Stankiewicz Krista Stone James Strickland Carey Vaughan Flynn Warren Member investors (up to $150) Sylvia Adams Casey Allen-Hayes Myron Anderson Jim Anderson Ann Ayers Suzanne Bagby Gary Bailey Marla Banks Richard Bass India Bauder Thomas Beckham William Bedingfield Fred Bishop Karen Braden
Kaitlin Brannen Marcia Brock Winston Brock Jesse Brown Diane Brown Wendy Buttrey Ron Cain Stephanie Cann Robert Cecil Tina Chancy Melissa Chewning David Clements David E Clements, Sr. Dawn Collier Margaret Collins-Free Chandler Conner Robert Cook Hewlette Cook Meryl Cook Raye Coplin Matthew Crist Betsy Crowder Amanda Crowe William Crowley Richard Crumpton J. Ernie Culpepper Charles Culpepper Mary Dalziel Ann Damon Angela Davis Suleman Daya Stacy Dickens Jessica Duffey Sheila Dukes Terry Dunn Eric Durham Robert Dykes David Eldridge Larry Ellis Frank Erwin
John Ewing Michael Farmer Vernon Ford Michelle Ford Matthew Frazier Elbert Fricks Raymond Fulp John Galdo Richard Garrett John Gleaton Samuel Goldberg Eric Goldstein James Goodson Richard Griffin Edmund Hackney Michelle Hamel Johnathan Hamrick Maxwell Hancock John Hansford Bobby Harrell Winton Harris Joshua Hartsell Earl Henderson Shawn Hodges Clay Hogan Joe Holt Woody Hunt James Hunt Mark Hurley Scotty Jarvis Johnny Joe Elizabeth Johnson Jami Justus Payal Kakadiya E. Kemp Charles King Amy King Erin Kovarik Charles Kovarik Georgie Langford
(CONTINUED)
Edwin Laws Allison Layne John Leffler Eddie Madden Ralph Marett Tyler Mayotte Susan McCleer Herbert McGinty Charles McWilliams James McWilliams Aubrey Miller Rodney Miller Hani Mussad Anita Naik Albert Nichols Charles Nicholson Anna Oberste Robert Oliver Brenda Owens Amanda Paisley Carl Parker Larry Parrish F Paul Kelli Peavy Amon Peters Christy Phillips-Malcom Whitney Pickett Rose Pinkstaff Kimberley Potter Lewis Powell Perry Prather Robert Probst Jeff Ratliff Ola Reffell F. Paul Rhett Ashley Rickard Donna Riggins Gerald Riggins Tom Roberts Carlos Rodriguez-Feo
Daniel Royal John Sandlin Edward Schutter Bryan Scott Jennifer Shannon Gary Sheffield Thomas Sherrer Brice Sikes Michael Sims Chad Smith James Strickland William Tatum Leonard Templeton Tim Thompson Sonny Thurmond Charles Tigner Tommy Tolbert F. Trotter Edward Turner Laura Tyson Christopher Vaughan Sheila Walker H. Weitman David Wells Rebecca White Mark White Douglas Wilkinson Jonathon Williams Timothy Wilson Keith Winslette Stephen Winslette Christopher Winslow Mark Winters William Wolfe William Wood Larry Woodruff Joseph Woodson Curant Health Integrated Financial Gp.
HELP US REACH OUR GOAL FOR 2016! In this election year it’s critical that PharmPAC raises enough funding to support pro-pharmacy candidates for the Georgia legislature. You can bet the PBMs will be well funded!
As of August 31, 2016
$95,829.50
$0
$25,000
$50,000
$75,000
$100,000
$125,000
Thank you to all our PharmPAC investors for their contributions to the future of pharmacy in Georgia. Visit GPhA.org/PharmPAC or call (404) 419-8118 to find out more.
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Get in touch
REACH US AT 404.231.5074 OR GPhA.ORG OPEN
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GPhA LEADERSHIP President & Chair of the Board LANCE BOLES, Hartwell lanceboles@hotmail.com President-Elect LIZA CHAPMAN, Dawsonville liza.chapman@kroger.com First Vice President TIM SHORT, Cumming garph9@aol.com Immediate Past President TOMMY WHITWORTH, LaGrange twhitworth@corleydrug.com Chief Executive Officer SCOTT BRUNNER, CAE sbrunner@gpha.org Directors MICHAEL AZZOLIN, Bishop azzolinm@pharmdondemand.com SHARON DEASON, Newnan sdeason99@hotmail.com AMY MILLER, Gainesville amylulapharmacy@gmail.com FRED SHARPE, Albany fsharpe@u-save-it.com JONATHAN SINYARD, Cordele sinyardj@gmail.com RENEE SMITH, Columbus rdapharmd1995@gmail.com CHRIS THURMOND, Athens vildrug@bellsouth.net
October/November 2016
For membership questions Mary Ritchie Director of Membership Operations (404) 419-8115 mritchie@gpha.org For questions about our magazine, blog, websites, or social media 1 Andrew Kantor Director of Communication akantor@gpha.org For questions about our educational offerings Phillip Ratliff Education Consultant pratliff@gpha.org For questions about any of our insurance products Denis Mucha Manager — Member Services (404) 419-8120 dmucha@gpha.org For questions about governmental affairs Greg Reybold Vice President of Public Policy greybold@gpha.org For questions about the Board of Directors or for scheduling the CEO Ruth Ann McGehee Executive Assistant and Governance Manager (404) 419-8173 rmcgehee@gpha.org
For operational or accounting questions: Dianne Jones Vice President of Finance & Administration (404) 419-8129 djones@gpha.org Patricia Aguilar Accounting Coordinator paguilar@gpha.org (404) 419-8124
For assistance with independent-pharmacy issues Jeff Lurey, R.Ph. VP of Independent Pharmacy (404) 419-8103 jlurey@gpha.org For questions about your AIP membership Verouschka “V” Betancourt-Whigham Manager of AIP Member Services (404) 419-8102 vbwhigham@gpha.org AIP Member Service Representatives Rhonda Bonner (229) 854-2797 rbonner@gpha.org Charles Boone (478) 955-7789 cboone@gpha.org Melissa Metheny (678) 485-6126 mmetheny@gpha.org
GPhA’S MEMBER SERVICE PARTNERS InfiniTrak infinitrak.us Track and trace compliance software (844) 464-4641 Pharmacy Quality Commitment pqc.net Quality assurance compliance resources (866) 365-7472 Pharmacy Technician Certification Board ptcb.org (800) 363-8012 SoFi sofi.com/gpha Student-loan refinancing (855) 456-7634 UBS ubs.com/team/wile Financial planning (404) 760-3000
Got a concern about a GPhA program or service? Want to compliment or complain? Drop a note to membercare@gpha.org.
Gene Smith (423) 667-7949 gsmith@gpha.org
Georgia Pharmacy 27
postscript
Securing our future Webster defines ‘security’ as the state of being protected or safe from harm or things that are done to make people or places safe. As this issue of Georgia Pharmacy has focused on pharmacy security, I would like to LANCE BOLES challenge you to think of ways that we can contribute to securing a better future for the profession of pharmacy. We currently operate in a system whereby roughly 50 percent of all prescriptions dispensed in the majority of pharmacies are paid for by dollars derived from the federal government. It is clear the impact that the federal government exerts over our profession through product reimbursement. There are several bipartisan initiatives before Congress that stand to both protect and provide service opportunities for pharmacists. Just last week, NCPA announced a House and Senate version of a resolution to ban retroactive
DIR fees, touted as a way to reduce cost sharing at the pharmacy for our patients, improve integrity in the Medicare Part D system — and do both with cost neutrality. A coalition of pharmacy groups led by APhA continues to gain support for provider status and to recognize pharmacists as providers, thus making pharmacists eligible to receive payment for services from Medicare that we are already trained to provide. There is also federal MAC transparency legislation proposed to ensure fair and equitable treatment to pharmacies that participate in federal programs.
And now a call to action: an opportunity
that we all can take to secure and expand the profession of pharmacy and the many opportunities for patient care that come with being a pharmacist. There are a number of ways that each of us can contribute to the goal of securing a better future for our profession. n Get to know your representatives in Congress — it’s important that your members of Congress have a pharmacist’s expertise to call on when there are issues that are affecting our profession. n Host a member of Congress in your practice setting. GPhA can provide you contact information and talking points if you would like to host a visit. n Ask your member of Congress to sign on and support each of these three key pieces of federal pharmacy legislation I mentioned, if they have not already. n Join APhA, ASHP, NACDS, or NCPA at their annual legislative conference for an opportunity to meet with your members of Congress and their staffs in Washington D.C. Georgia Pharmacy A S S O C I AT I O N
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Lance Boles is GPhA’s 2016-2017 president and owner of independent pharmacies in Hartwell, Ga. and Iva, S.C. 28 Georgia Pharmacy
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